连续性血液净化治疗对急性胰腺炎的临床效果和预后状况分析

目的:探讨连续性血液净化(CBP)对急性胰腺炎(AP)的治疗效果及预后的影响。方法:选取2010年1月至2016年12月间我院1200例AP患者作为研究对象,按照随机数字表法分为常规治疗组及CBP治疗组,每组600例。常规治疗组接受常规药物治疗,CBP治疗组在常用药物治疗的基础上联合应用CBP治疗。对比治疗后两组患者临床症状消失时间以及治疗前、治疗后72h炎性因子水平变化情况和肠道功能变化情况,并对比两组治疗后7 d的死亡率。结果:CBP治疗组治疗后的腹痛消失时间、腹胀消失时间及腹部压痛消失时间均低于常规治疗组(P0.05)。两组治疗前内毒素、C反应蛋白(CRP)、淀粉酶(AMS)、二胺氧化酶及丙二醛比较无统计学差异(P0.05);治疗后72 h,内毒素、CRP、AMS、二胺氧化酶及丙二醛水平均较治疗前降低,且CBP治疗组低于常规治疗组(P0.05)。治疗后7 d CBP治疗组死亡率低于常规治疗组,差异具有统计学意义(P0.05)。结论:CBP可有效的提高AP的临床治疗效果,并改善患者的临床预后。

Clinical Effect and Prognosis of Continuous Blood Purification in Patients with Acute Pancreatitis

ABSTRACT Objective: To investigate the therapeutic effect of continuous blood purification (CBP) on acute pancreatitis (AP) and its influence on prognosis. Methods: 200 patients with AP in our hospital from January 2010 to December 2016 were selected as the subjects, and they were divided into conventional treatment group and CBP treatment group according to the random number table method, 600 cases in each group. The conventional treatment group was received conventional drug therapy, and the CBP treatment group was treated with CBP on the basis of commonly used drugs. The disappeared time of clinical symptoms after treatment and the changes of inflammatory factors and the changes of intestinal function before and 72 h after treatment were compared between the two groups,the mortality rate was compared between the two groups at 7 d after treatment. Results: Abdominal pain disappeared time, abdominal distension disappeared time and abdominal tenderness disappeared time in CBP treatment group after treatment were lower than the conventional treatment group (P<0.05). There was no significant difference in the levels of endotoxin, C reactive protein (CRP),amylase (AMS), two amine oxidase and malondialdehyde before treatment in the two groups (P>0.05). At 72 h after treatment, endotoxin, CRP, AMS, two amine oxidase and malondialdehyde levels were lower than those before treatment, and the CBP treatment group was lower than the conventional treatment group (P<0.05). The mortality rate of CBP treatment group was lower than that of conventional treatment group at 7 d after treatment, the difference was statistically significant (P<0.05). Conclusion: CBP can effectively improve the clinical therapeutic effect of AP, and improve the clinical prognosis of patients.